ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2021
Abnormal neurological pupil index is associated with malignant cerebral edema after mechanical thrombectomy in large vessel occlusion patients.
Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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10 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Risk prediction models for malignant cerebral edema after endovascular therapy in patients with acute anterior circulation large vessel occlusion stroke: a systematic review and meta-analysis.Frontiers in neurologyPooled it
- Association of Blood-Based Biomarkers and Malignant Infarction in Severe Anterior Circulation Ischemic Stroke.Brain and behavior · 2026Article
- Association between hyperglycemia and unfavorable outcome in patients with successful thrombectomy for acute ischemic stroke: a single-center study.BMC neurology · 2025Article
- Article
- Development and validation of an interpretable machine learning model to predict malignant cerebral edema after endovascular treatment in acute anterior circulation large vessel occlusion stroke.Frontiers in neurology · 2025Article
- Dynamically Normalized Pupillometry for Detecting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage.Critical care explorations · 2024Observational
- Automated Pupillometry Is Able to Discriminate Patients with Acute Stroke from Healthy Subjects: An Observational, Cross-Sectional Study.Brain sciences · 2024Article
- Pupillometry in the follow-up of patients undergoing EVT - prediction of space-occupying hemispheric infarction.Journal of neurology · 2023Article
- Application of Pupillometry in Neurocritical Patients.Journal of personalized medicine · 2023Review
- The stress hyperglycemia ratio is associated with the development of cerebral edema and poor functional outcome in patients with acute cerebral infarction.Frontiers in aging neuroscience · 2022Article
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12 authors at 2 institutions in 1 country.
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Abstract
BACKGROUND AND
objectivesMalignant cerebral edema (MCE) is a feared complication in patients suffering from large vessel occlusion. Variables associated with the development of MCE have not been clearly elucidated. Use of pupillometry and the neurological pupil index (NPi) as an objective measure in patients undergoing mechanical thrombectomy (MT) has not been explored. We aim to evaluate variables significantly associated with MCE in patients that undergo MT and hypothesize that abnormal NPi is associated with MCE in this population.
methodsA retrospective analysis of patients with acute ischemic stroke who had undergone MT at our institution between 2017 and 2020 was performed. Baseline and outcome variables were collected, including NPi values from pupillometry readings of patients within 72 h after the MT. Patients were divided into two groups: MCE versus non-MCE group. A univariate and multivariate analysis was performed.
resultsOf 284 acute ischemic stroke patients, 64 (22.5%) developed MCE. Mean admission glucose (137 vs. 173; p < 0.0001), NIHSS on admission (17 vs. 24; p < 0.01), infarct core volume (27.9 vs. 17.9 mL; p = 0.0036), TICI score (p = 0.001), and number of passes (2.9 vs. 1.8; p < 0.0001) were significantly different between the groups. Pupillometry data was present for 64 patients (22.5%). Upon multivariate analysis, abnormal ipsilateral NPi (OR 21.80 95% CI 3.32-286.4; p = 0.007) and hemorrhagic conversion were independently associated with MCE.
conclusionAbnormal NPi and hemorrhagic conversion are significantly associated with MCE in patients following MT. Further investigation is warranted to better define an association between NPi and patient outcomes in this patient population.
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